Provider Demographics
NPI:1659493369
Name:WOOLLCOTT, PATRICIA GEPPERT (RN, CNM)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:GEPPERT
Last Name:WOOLLCOTT
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 S LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-9115
Mailing Address - Country:US
Mailing Address - Phone:231-242-0747
Mailing Address - Fax:
Practice Address - Street 1:1003 SPRING ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2810
Practice Address - Country:US
Practice Address - Phone:231-347-9692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704247974367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife